Nigeria And The Burden Of Combating Malnutrition

Malnutrition, which results in death, stunting, underweight and wasting among children under age five, has remained a serious concern in Nigeria as the statistics continues to ascend.
The United Nations Children’s Funds (UNICEF), has said that stunting is what happens to a child’s brain and body when they don’t get the right kind of food or nutrients in their first 1,000 days of life. It also estimated that about 11 million children under the age of five are stunted in Nigeria.
The 2013 National Demographic Health Survey (NDHS) put prevalence of stunting at 37 per cent, underweight at 29 per cent and wasting at 18 per cent for children under five years of age.
NDHS also estimated that more than five million newborns in Nigeria lack essential nutrients and antibodies that would prevent them from diseases and death as they are not being exclusively breastfed.

The 2016-2017 Multiple Indicator Cluster Survey (MICS) report has also showed an increase in malnutrition indices as it puts stunting at 43.6 per cent , wasting at 10.8 per cent, underweight at 31.5 per cent and overweight at 5.5 per cent among children less than five years old. These worrisome statistics prompted the call by the Civil Society Scaling Up Nutrition in Nigeria, (CS-SUNN) on governments at all levels to domesticate and fully implement the Multi- Sectoral Plans of action for nutrition.The group, which made the call recently in Abuja, at a Project Inception Media Roundtable on the Partnership for Improving Nigeria Nutrition Systems (PINNS), urged governments to provide adequate funding for nutrition in all nutrition line ministries’ annual budgets and to ensure that nutrition services are prioritised and funded from the 1% Consolidated Revenue Fund at Primary Health Care facilities.
CS-SUNN’s Executive Secretary, Beatrice Eluaka, lamented that malnutrition remains a key contributor to infant and maternal mortality and morbidity, poor cognitive development, increased severity of diseases which adversely affects productivity in the country.
She identified ineffective coordination of nutrition activities across the country, inadequate fund allocations and releases for nutrition and low uptake of preventive measures for combating malnutrition such as exclusive breastfeeding and optimal infant and young child feeding practices as some of the challenges bedeviling the Nigerian Nutrition System.

Also, UNICEF Deputy Country Representative, Isiye Ndonbi, has expressed concern over what he described as drastic reduction in the country’s health budget in the last years, saying it has a really negative undertone to what was available.
He said “the funds that were allocated for food and lifesaving drugs for children that are malnourished has also been cut. The initial allocation for this activity was N1.2b which would have allowed the provision of treatment to 86,000 children in Nigerian and it would have saved 16,000 of them. However the approved budget right will only allow to carter for 28,000 children down from 86,000, this is a negative development.”
However, Nigeria, last week, flagged off the 2018 World Breastfeeding Week, with the theme: ‘Breastfeeding: Foundation of life’. WBW is celebrated globally to protect, promote and support early initiation, exclusive and continued breastfeeding for the survival, growth and development of the child.
Harping on exclusive breastfeeding as key to combating all forms of malnutrition by 2030, the minister of Health, Prof. Isaac Adewole, said that the theme of this year’s WBW is meant to reawaken the focus of Nigerians on the importance of breastfeeding as the ‘building block’ for food and nutrition security to infants and young children with a view to preventing all forms of malnutrition.

The World Breastfeeding Week was first celebrated in 1992 as a strategy for creating awareness amongst all stakeholders on the importance of breastfeeding to child survival. It was also carried out as a follow to the 1990 Innocenti Declaration on the Protection, Promotion and support of breastfeeding.
The minister however regretted that even though Nigeria has continued to use the platform to promote optimal Infant and Young Child Feeding since the first celebration, the country’s infant and young feeding indices are still unacceptably poor.
He pointed out that a breastfed child has been provided ideal nutrition as a contributor to his/her healthy growth and development. “That child is protected from incidence and severity of infectious diseases resulting in lower morbidity and mortality. The breastfed child, especially, the one that is exclusively breastfed in the first six months of life, rarely falls sick. This brings savings to the family through reductions in hospital expenditure and the returns can be utilized for other needs in the family,” he explained.
Adewole added that the mother also benefits from the gains of optimal breastfeeding practices. “The unrestricted practice of exclusive breastfeeding helps the post-partum mother’s womb to return to normal shape, her chances of having breast and ovarian cancers are reduced and it contributes to an increase in the space between pregnancies; and her health status is improved considerably before her next pregnancy.
“Additionally, there are lots of social and economic benefits to the family and the nation. There is also a sense of satisfaction when breastfeeding is successfully carried out; especially exclusively in the first six months of life, and thereafter with increased duration involving breastfeeding and complementary foods. This can result in positive changes in the health status of the family,” he said.

he therefore called for continues collaboration of all stakeholders towards achieving success in the fight, saying that achieving the targets of breastfeeding and other nutrition indicators in the National Strategic Plan of Action (NSPAN) will help partly to contribute to the achievement of Universal Health Coverage and the Sustainable Development Goals (SDGs).
Meanwhile, stakeholders have stressed the need for adequate and continuous care for pregnant women during pregnancy and after delivering as study has shown that adolescent and maternal nutritional status are intertwined with the nutritional and health status of the child especially within the first 1,000 days of life.
In an exclusive interview with LEADERSHIP, Public Health Nutritionist, Nutrition Division, Family Health Department, Federal Ministry of Health, Kobata Thompson, said that there is a global trend to make adolescent and maternal nutrition agenda visible as determinants to the prevention of malnutrition.
According to her, “the period from birth to two years of age is the “critical window” for the promotion of optimal growth, health and development of the child. Adequate nutrition during infancy and early childhood is fundamental to child’s growth and development to full potential. This spans from the girl child to adolescent through to pregnancy- a continuum of care.”
She informed that most important organs like the brain, eyes, ears and heart develop before a mother knows for sure she is pregnant, adding that malnutrition of the mother can result in disability of the baby or even a miscarriage.

Dr. Thompson also said that inadequate nutritional practices begin with poor universal breastfeeding practices which drawback the child, mother, family and nation at large. Adding that inadequate nutritional practices can lead to 823,000 under five deaths, cost the government more than $300 billion annually and 20,000 breast cancer deaths annually.
“Over two-thirds of U5 deaths in Nigeria, which are often associated with inappropriate feeding practices, occur during the first year of life. Poor feeding practices are among the most serious obstacles to attaining and maintaining health that face children under the age of five in Nigeria.
“Complementary feeding frequently begins too early or too late, and foods are often nutritionally inadequate and unsafe,” she added.
On achieving the global nutritional targets for 2030, Thompson said that Nigeria plans to reduce anaemia from 67 per cent in 2013 to 40 per cent in 2025, increase exclusive breasthe current or past pregnancy within the last two years and availability of national breastfeeding counseltfeeding from 17 per cent to 65 per cent, reduce stunting from 37 per cent in 2013 to 18 per cent and wasting from 18 per cent is 2013 to 10 per cent in 2025.
She however urged all stakeholders, including mothers to protect, promote and support exclusive breastfeeding for six months and continued breastfeeding for two years or beyond for child’s survival, growth, development and improved maternal health being.